| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.09 | $0.09 | $0.09 | |
Aetna
| Professional | $0.09 | $0.09 | $0.09 | |
Asuris Northwest Health
| Professional | $0.11 | $0.11 | $2.00 | |
Molina
| Professional | $50.00 | $50.00 | $80.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |